Bone health among indoor female athletes and associated factors; a cross-sectional study.

This study aimed to compare the bone-mineral-density (BMD), vitamin-D (25(OH)D), serum-calcium and serum-phosphorus levels between female athletes engaged in weight-bearing and non-weight-bearing-sport, and to evaluate possible associations among studied variables. Study involved top-level female athletes (age: 16.9 ± 4.4 years) involved in non-weight-bearing- (swimming; n = 14)), and weight-bearing-sport (artistic gymnastic; n = 17). The variables included the BMD of left femoral neck (measured by dual-energy X-ray absorptiometry), 25-hydroxyvitamin D levels (25(OH)D), body height, body mass, body-mass-index, serum-phosphorus, and serum-calcium levels. Sufficiency for 25(OH)D (>75 nmol/L) was observed in 32.3% of the studied athletes (43% and 23% for swimmers and gymnasts, respectively). The studied athletes had appropriate BMD, with higher BMD in gymnasts compared to swimmers (1.24 ± 0.11 and 0.85 ± 0.09 g/cm2; t-test: 10.26, p < 0.01). Serum-phosphorus was higher in gymnasts (1.46 ± 0.17 and 1.27 ± 1.36 mmol/L, t-test: 2.78, p < 0.01. Serum-phosphorus levels were lower in athletes with 25(OH)D sufficiency (t-test: 2.31, p = 0.03). The 25(OH)D was not correlated to BMD (Pearson's r = -0.18, -0.14, -0.28, all p > 0.05, for total sample, gymnasts and swimmers, respectively). Although 25(OH)D was not correlated with BMD, in further investigations other assays of vitamin-D status (i.e. the bioavailability of the vitamin-D) should be included.

Examination of Factors Explaining Coaching Strategy and Training Methodology as Correlates of Potential Doping Behavior in High-Level Swimming.

Although coaching is considered an important determinant of athletes' potential doping behavior (PDB), there is an evident lack of studies that have examined coaching-strategy-and-training-methodology (CS&TM) in relation to PDB. This study was aimed to identify the specific associations that may exist between CS&TM -factors and other factors, and PDB in high-level swimming. The sample comprised 94 swimmers (35 females; 19.7 ± 2.3 years of age) and consisted of swimmers older than 18 years who participated in the 2017 National Championship. Variables were collected by previously validated questionnaires, with the addition of questions where athletes were asked about CS&TM to which they had been exposed. Multinomial logistic regression was applied for the criterion PDB (Negative PDB - Neutral PDB - Positive PDB). The higher risk for positive-PDB was found in males (OR: 6.58; 95%CI: 1.01-9.12); therefore, all regressions were adjusted for gender. Those swimmers who achieved better competitive result were less prone to neutral-PDB (0.41; 0.17-0.98). The positive-PDB was evidenced in those swimmers who perceived that their training was monotonous and lacked diversity (1.82; 1.41-5.11), and who were involved in training which was mostly oriented toward volume (1.76; 1.11-7.12). The lower likelihood of positive-PDB is found in those who replied that technique is practiced frequently (0.12; 0.01-0.81), those who replied that coach regularly provided the attention to explain the training aims (0.21; 0.04-0.81), and that coach frequently reviewed and discussed the quality of execution of specific tasks (0.41; 0.02-0.81). The findings on the relationships between the studied variables and PDB should be incorporated into targeted anti-doping efforts in swimming. Further studies examining sport-specific variables of CS&TM in younger swimmers and other sports are warranted.

Alcohol Drinking Among Kosovar Adolescents: An Examination of Gender-Specific Sociodemographic, Sport, and Familial Factors Associated With Harmful Drinking.

BACKGROUND: Adolescent alcohol consumption is a significant public-health problem, although there is a lack of studies investigating this issue in Kosovo. OBJECTIVES: The aim of this investigation was to examine the prevalence of alcohol drinking, and the factors associated with harmful drinking (HD) in Kosovar 17-18 years old adolescents. METHODS: The sample comprised 636 girls and 366 boys (17-18 years old) from Pristina, Kosovo. The independent variables included sociodemographic factors, variables examining familial-monitoring and conflict (familial-variables), and sport-factors. Alcohol-drinking (dependent variable) was measured by means of the alcohol use disorders identification test scale. RESULTS: 39% of the girls and 43% of the boys reported HD (odds ratio (OR) = 1.17; 95% confidence interval = 0.90-1.55). A higher likelihood of HD is found for those girls whose mothers have an advanced education (OR = 1.59), who reported a higher level of conflict with their parents (OR = 1.95), whose parents are frequently absent from home (OR = 1.93), and who reported lower religiosity (OR = 0.90). HD is more frequent among boys who have participated longer in sports (OR = 1.49), whose fathers have an advanced education (OR = 1.80), and who reported higher level of familial conflict (OR = 2.87). CONCLUSIONS/IMPORTANCE: The prevalence of HD is high. Knowing the problems related to alcohol drinking in girls (violence, trafficking, etc.), public-health authorities should urgently develop a specific preventive programme (SPP) to combat the misuse of alcohol. In preparing SPP, special attention should be paid to the varying influences of the studied factors on HD in boys and girls.

The Effects of an Eight-Week Swimming Program on Body Composition and Assessment of Dietary Intake in Post-COVID-19 Patients.

COVID-19 infection and its consequences (long-term COVID-19 syndrome) have implications for weight loss, body composition, and diet quality. In the context of the "PostCovSwim" project, which is part of a broader international study, the impact of an eight-week swimming program on post-COVID-19 patients' nutritional status (i.e., body composition and dietary intake) was evaluated. Body composition and dietary intake were assessed by medically approved and calibrated bioelectrical impedance (Tanita 780 S MA) and food frequency questionnaires. At the baseline, most participants were classified as overweight based on their body mass index (BMI). However, their body fat percentage (BF%) classification indicated normal weight, although females were near obesity thresholds. Furthermore, at the baseline, according to the BMI classification, 62% of females and 61% of males were female, whereas according to the BF% for obesity classification, 44% of females and 43% of males were considered overweight or obese. Surprisingly, despite the eight-week program, there were no significant changes in body composition. Additionally, the assessment of dietary intake, which remained consistent throughout the study, revealed dietary imbalances characterized by an unhealthy low-carbohydrate, high-fat dietary pattern. This dietary pattern entailed excessive consumption of ultraprocessed foods; reduced carbohydrate intake (39% E vs. 37% E); increased total fat intake (46% E vs. 47% E); increased saturated fatty acids (14% E vs. 13% E); increased cholesterol (412 mg/d vs. 425 mg/d); increased free sugars (7% E vs. 7% E); and inadequate intake of fibre (24 g/d vs. 20 g/d), polyunsaturated fatty acids (6.6% E vs. 7.7% E), vitamin B12 (in females: 3.1 µg/d), vitamin C (86 mg/d vs. 66 mg/d), vitamin D (2 µg/d vs. 3.2 µg/d), folate (in males: 258 µg/d), calcium (777 mg/d vs. 743 mg/d), and selenium (in males: 66 µg/d). After an eight-week swimming program following COVID-19, no significant changes were observed in the subjects' body composition. Their dietary intake was found to not align with the dietary recommendations. These findings underscore the urgency of implementing comprehensive dietary and lifestyle interventions for post-COVID-19 patients to optimize their recovery and overall well-being. Physical activity, like a swimming program, may positively affect various aspects of human well-being.

Sport nutrition and doping factors in swimming; parallel analysis among athletes and coaches.

The sport nutrition and doping are known to be important issues in sports, but there is evident lack of studies which investigated those issues in swimming, especially with regard to parallel analysis of coaches and athletes. The first aim of this study was to compare knowledge of swimming coaches and their athletes about nutrition and doping. Also, we have identified interrelationships between studied sociodemographic-, sport-; nutrition- and doping-related-factors. The sample of subjects comprised 55 athletes (20.3 +/- 2.2 years of age; 24 females) and 22 coaches (mean age 36.5 +/- 7.8 years; 4 females) from Croatia (98% of respondents). In the first phase of the investigation we have validated specific questionnaires to determine the knowledge of sport nutrition (KSN), and knowledge on doping (KD). The test-retest correlation and percentage of equally responded queries revealed both questionnaires as reliable. The discriminative validity was proven also since coaches scored better than their athletes on both questionnaires. Athletes declared their coaches as the primary sources of knowledge about nutrition and doping. Among coaches, formal and self-education are equally important sources of information about doping and nutrition. The age is negatively, while the formal education is positively correlated to KD and KSN scores among coaches. Consequently, permanent educational programs about nutrition and doping are emphasized, especially among older coaches and younger athletes.

Olympic Cycle Comparison of the Nutritional and Cardiovascular Health Status of an Elite-Level Female Swimmer: Case Study Report from Slovenia.

Monitoring the many aspects that are crucial to an athlete's performance progress is vital for further training planning and for the development of performance and the sport. We evaluated a four-year change (2018 vs. 2022) in the current nutritional and cardiovascular health status of the most successful elite-level female swimmer in Slovenia. Body composition and dietary intake were assessed using dual-energy X-ray absorptiometry and a standardized food questionnaire. The concentration of blood lipids, blood pressure, and serum micronutrients (B12, 25(OH)D), potassium, calcium, phosphorus, magnesium, and iron) were measured. The four-year comparison showed an improved body composition status (i.e., increased body mass and decreased body fat (percentage and mass), increased lean soft tissue and total bone mineral density (BMD) (i.e., significantly decreased BMD of a left femoral neck and increased BMD of a spine and head)). We also measured an improvement in the cardiovascular health status of some markers (i.e., decreased total cholesterol, triglycerides, and blood pressure but increased low-density lipoprotein cholesterol), most likely due to the differences in assessed dietary intake (i.e., lower carbohydrate intake, higher total and saturated fat intake, and lower sodium intake). Notably, nutrient intakes that are generally of concern (eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), vitamin B12 and D, calcium, iron, and zinc (except for fiber intake)) were all within recommended ranges. However, the athlete's vitamin K and potassium intake were not adequate. Furthermore, in 2018, the athlete did not consume dietary supplements, while she now regularly uses several dietary supplements, including EPA and DHA omega-3, vitamin D, multivitamins, carbohydrate powder, and sports drink. Moreover, from the micronutrient serum, only iron levels deviated from the reference values (37 µmol/L vs. 10.7-28.6 µmol/L). The presented screening example using valid, sensitive, and affordable methods and with rapid organizational implementation may be a viable format for regular monitoring.

How University Students Assess Their Water Skills.

The aim of this study was to determine the gender differences between students' actual and perceived water abilities, how respondents assess risk in the described situations, and whether there are gender differences for those situations. The cross-sectional study was conducted on 150 students aged 19-20 years (males, n = 88; females, n = 62) from the faculty of sport and physical education, University of Novi Sad. Using calculated frequencies and estimates, students' self-assessment and actual measures of their swimming and survival skills and their perceived risk of drowning are described. Based on the results, Mann-Whitney U tests were applied. The differences between independent variables (gender) were analyzed according to dependent measures (water competency). To determine the significance of the relationship between actual and perceived skills, Spearman-rank correlation coefficients were calculated. The results of this study confirmed gender differences between students' actual and perceived water abilities, and that the male and female students had inaccurate perceptions of their own perceived and real water abilities. Both male and female students, with high precision, assessed their ability to swim long distances (rs = 0.601; rs = 0.694) just as female students assessed their ability to float (rs = 0.698). Male students greatly overestimated their backstroke swimming, while female students underestimated their ability to dive into the water. Both groups overestimated underwater swimming and underestimated their surface dive skill. Also, there was gender differences between students in assessing the risk for described situations.

Body Composition, Training Volume/Pattern and Injury Status of Slovenian Adolescent Female High-Performance Gymnasts.

Body composition (BC), training volume/pattern, and injury status are a few important factors affecting training quality and sport performance in female artistic gymnastics. We aimed to examine BC status, training volume/pattern, and injury status during the first competition period. Our cross-sectional study included 17 female gymnasts (age: 17.4 ± 4.1 years, body height: 159.8 ± 6.2 cm, and body weight: 54.8 ± 5.3 kg) who were high performance at the international and national level. The BC (measured by dual-energy X-ray absorptiometry) parameters included body height and mass, body fat percentage (BF %), lean body mass (LBM), body mass index (BMI), total bone mineral density (BMD total), and total bone mineral content (BMC total). Training volume and pattern were assessed via an author-developed questionnaire, while injury status (i.e., anatomical location, symmetry and rate of injuries) was assessed via a modified questionnaire on overuse injuries used in sports injury epidemiology studies with elite-level athletes. Body composition parameters were as follows: the BMI was 21.5 ± 1.4 kg/m2, BF % was 21.9 ± 4.7%, LBM was 41.2 ± 3.4 kg, BMD total was 1.22 ± 0.08 g/cm2, and BMC total was 2486 ± 344 g. Furthermore, the average weekly volume of training was 23.5 ± 1.4 h, with the highest training volume occurring on Monday and Tuesday and high variability within gymnasts. Our study also revealed that the most frequently injured joints that had the most negative impact on training volume, sport performance and pain status were the ankles and low back, followed by the knees and shoulders. This kind of yearly screening method is warranted to allow more definitive conclusions to be made on adjusted training and preventive strategies.

Nutritional Status and Cardiovascular Health in Female Adolescent Elite-Level Artistic Gymnasts and Swimmers: A Cross-Sectional Study of 31 Athletes.

OBJECTIVE: Nutritional status is important for health and competitive achievement. This area remains understudied among elite-level female athletes and is appropriate for research. We examined nutritional status and cardiovascular health markers of two groups of female athletes of the same age and competition period, involved in weight-bearing and a non-weight-bearing sport: gymnasts (n = 17) and swimmers (n = 14); mean age 17.4 and 16.6 years. METHODS: Body composition and dietary intake were assessed by bioelectrical impedance and Food Frequency Questionnaire. The concentrations of serum micronutrients (B12, 25-hydroxyvitamin D (25 (OH) D), calcium, magnesium, phosphorus, potassium, and iron), blood lipids, and blood pressure (BP) were measured. Setting and Participants. A cross-sectional study of 31 athletes from Slovenia. RESULTS: Gymnasts had higher body mass index (21.5 vs. 20.1 kg/m2, p=0.043) and lower fat free mass (42.4 vs. 46.6 kg, p=0.024) than swimmers and comparable body fat percentage (22.5 vs. 22.8%). Both groups had low intake of carbohydrates, fibre, polyunsaturated fats, protein (only gymnasts), and micronutrients (11/13 micronutrients gymnasts and 4/13 swimmers) and high intake of free sugars and saturated fats. Both groups also had significantly lower-than-recommended serum levels of 25 (OH) D. All cardiovascular risk factors were within recommended ranges. Gymnasts had higher LDL cholesterol (2.7 vs. 2.2 mmol/L, p < 0.011), and swimmers had higher systolic BP (126 vs. 107 mmHg, p < 0.001). CONCLUSIONS: Dietary intake especially in gymnasts was suboptimal, which may reflect in anthropometric and cardiovascular marker differences between gymnasts and swimmers.

Toward Prevention of Doping in Youth Sport: Cross-Sectional Analysis of Correlates of Doping Tendency in Swimming.

Doping is recognized as one of the most important problems in sports, but a limited number of studies have investigated doping problems in youth athletes. This study aimed to evaluate doping tendency (potential doping behavior (PDB)) and correlates of PDB in youth age swimmers. The participants were 241 competitive swimmers (131 females; 15.3 ± 1.1 years of age, all under 18 years old). Variables included predictors and PDB (criterion). Predictors consisted of sociodemographic factors (gender and age), sport-related variables (i.e., experience in swimming and sport achievement), variables explaining coaching strategy and training methodology, consumption of dietary supplements (DS), knowledge about doping, and knowledge about sports nutrition and DS (KSN). In addition to the descriptive statistics and differences between genders, a multinomial regression using PDB as the criterion (negative-, neutral-, or positive-PDB, with a negative-PDB as the reference value) was calculated to define associations between predictors and criterion. With only 71% of swimmers who declared negative-PDB results indicated an alarming figure. Boys with better KSN were more negatively oriented toward positive-PDB (OR: 0.77, 95%CI: 0.60-0.95). In girls, lower competitive achievement was evidenced as a risk factor for neutral-PDB (OR: 0.39, 95%CI: 0.24-0.63). Also, higher neutral-PDB (OR: 0.88, 95%CI: 0.81-0.96) and positive-PDB (OR: 0.90, 95%CI: 0.83-0.99) were identified in girls who began with intensive training in younger age. Because of the alarming figures of PDB, there is an evident need for the development of systematic antidoping educational programs in youth swimming. In doing so, focus should be placed on girls who began intensive training at an earlier age and those who did not achieve high competitive results.

Physical Activity, Body Mass, and Adherence to the Mediterranean Diet in Preschool Children: A Cross-Sectional Analysis in the Split-Dalmatia County (Croatia).

Physical activity, body mass, and dietary habits are known to be important determinants of overall health status, but there is an evident lack of studies that examine these issues specifically in preschool children. The aim of this study was to identify associations that may exist between adhering to the Mediterranean diet (MD), levels of physical activity (PA), and body composition indices in apparently healthy preschool children from southern Croatia. Participants were 5- to 6-year-old preschoolers from the Mediterranean part of the country (the Split-Dalmatia County; n = 260, 126 females). Adherence to the MD was observed by the Mediterranean Diet Quality Index (KIDMED), PA level was evaluated by the Preschool-age Children's Physical Activity Questionnaire (Pre-PAQ), and responses were collected from the parents. The participants' waist circumferences (in cm), waist-to-hip ratios, and body mass index (in kg/m2, and in a z-score calculated relative to the normative value for age and sex) were used as indicators of body composition. All children were of the same age and tested over a one-month period of the same year as a part of the regular examination undertaken before attending elementary school. With only 6% of the children having a low KIDMED score, adherence to the MD was high. MD adherence was higher in girls (Chi-square = 15.31, p < 0.01) and children who live on the coast of the Adriatic Sea (Chi-square = 18.51, p < 0.01). A mixed effects logistic regression (with kindergarten as random factor) identified sedentary activity to be negatively associated with MD adherence (OR per point: 0.65, 95% CI: 0.44-0.91). High adherence to the MD in the studied sample may be attributed to regulated feeding in kindergarten. Considering that most Croatian elementary schools do not provide food to their students, MD adherence should be investigated later in life and also in other parts of the country where the MD is culturally less prevalent.

Evidencing Protective and Risk Factors for Harmful Alcohol Drinking in Adolescence: A Prospective Analysis of Sport-Participation and Scholastic-Achievement in Older Adolescents from Croatia.

Background: The prevalence of alcohol drinking (AD) in Croatian adolescents is alarming, but there is an evident lack of prospective analyses of the protective/risk factors of AD. This study aimed to prospectively investigate the relationships between scholastic and sport factors and harmful alcohol drinking (HD) in older adolescents. Methods: The participants (n = 644, 53.7% females) were 16 years of age at study baseline and were tested at baseline and again 20 months later (follow-up). The predictors included four variables of scholastic achievement and four factors evidencing involvement in sport. Criterion was AD observed on the Alcohol Use Disorders Identification Test (AUDIT), and results were later categorized into harmful drinking (HD) and non-harmful drinking (NHD). The HD at baseline, HD at follow-up and HD initiation during the study course were observed as criteria in logistic regression analyses, which were additionally controlled for confounders (age, gender, socioeconomic status, and conflict with parents). Results: With 22% and 29% adolescents who reported HD at baseline and follow-up, respectively, the prevalence of HD remains among the highest in Europe. Scholastic failure was systematically related to HD at baseline and follow-up, but scholastic variables did not predict HD initiation during the course of the study. The higher odds for HD at baseline were evidenced for current and former team sport athletes. Those who quit individual sport were more likely to engage in HD at follow-up. Longer involvement in sport (OR: 2.10, 95% CI: 1.18⁻3.72), higher sport result (OR: 3.15, 95% CI: 1.19⁻8.34), and quitting individual sport (OR: 13.13, 95% CI: 2.67⁻64.62) were predictive of HD initiation. Conclusions: The results indicated specific associations between sport factors with HD initiation, which is understandable knowing the high stress placed on young athletes in this period of life, mainly because of the forthcoming selection between junior (amateur) and senior (professional) level. The results did not allow interpretation of the cause-effect relationship between scholastic failure and HD in the studied period.

The association between body-built and injury occurrence in pre-professional ballet dancers - Separated analysis for the injured body-locations.

OBJECTIVES: This study has aimed at identifying prevalence of injury-occurrence in 24 pre-professional-ballet-dancers (females, 16-18 years of age), and identifying the associations between the body-built and prevalence of injuries. MATERIAL AND METHODS: The sample of variables included: body mass, body height, and 3 somatotype characteristics (mesomorph, ectomorph and endomorph) and data on injuries over the preceding year. RESULTS: Dancers were mostly ectomorphic-mesomorph (endomorphy: 2.6±0.54, mesomorphy: 3.99±0.77, ectomorphy: 3.23±0.54). The most commonly injured locations were the foot (17% of all injuries) and ankle (17%). Majority of the injuries occurred while practising but 37% of hip-injuries occurred while performing. Ankle-injuries resulted in longest absence from ballet. Endomorphy was related to ankle-injury (odds ratio (OR) = 1.9, 95% confidence interval (CI): 1.4-2.3), ectomorphy to foot injury (OR = 1.7, 95% CI: 1.1-2.9), and body-mass to injury to the toes (OR = 1.7, 95% CI: 1.4-3.1). CONCLUSIONS: The results of this study allow for recognizing those dancers who are particularly vulnerable to injuries of certain body location. A more profound analysis of the possible mechanisms that lead to hip-injury during performance is needed. Int J Occup Med Environ Health 2017;30(1):151-159.

The reliability, validity and applicability of two sport-specific power tests in synchronized swimming.

Sport-specific tests are rarely investigated in synchronized swimming (synchro). The aim of this research was to study the reliability and the validity of two sport-specific tests that are based on synchro elements, namely, the Barracuda thrust ("Barracuda") and the Boost. The Barracuda is a move in which the swimmer begins in the back pike position (head down with the legs perpendicular to the surface of the water) and then moves the legs and hips rapidly upward, unrolling the body to obtain a maximal vertical position above the surface of the water. The Boost occurs when the swimmer rises rapidly out of the water, head first, to bring as much of the body as possible above the surface of the water. Both patterns are considered power moves and are therefore theoretically related to explosive strength. This study involved 22 female competitive synchro swimmers aged 16-18 years. The variables examined included performance on the Barracuda, Boost and countermovement jump and anthropometric measures (body height, body weight and body composition). Statistical analyses showed appropriate reliability for all tests, with no systematic bias between trials. A factor analysis calculated for the Barracuda, Boost and countermovement jump revealed one significant factor based on the Guttmann-Kaiser criterion with all three tests significantly projected. The structure of the significant factor did not change if the results for the Boost and Barracuda were normalized for body height. The Boost and Barracuda, but not the countermovement jump, were significantly correlated with the competitive achievements of the swimmers. In conclusion, the Boost and Barracuda are reliable and valid measures of the explosive strength of synchronized swimmers and are significantly related to competitive achievement.